Thigh lift

A thigh lift is an operation carried out to remove excess skin on the thigh and, where needed, to adjust the subcutaneous fatty tissue.¹ This article describes the incision on the inner side, the choice of an incision extending into the groin, the scar accepted in return, wound and lymphatic problems, the course of recovery, and the return to movement.

What is a thigh lift?

A thigh lift, also called thighplasty, addresses lax skin and excess soft tissue particularly on the inner side of the thigh.¹² It is not the same procedure as reducing fatty tissue alone; where skin elasticity is inadequate, removing fat may not on its own eliminate the sagging skin.¹

The area corrected on this page is the thigh. It is not expected to correct laxity of the skin below the knee.³ Bringing a person's whole leg to a single measurement, or treating a reduction in circumference alone as success, is not a suitable expectation. At examination, where the scar will remain in return is assessed as much as which excess will be removed.⁴⁵

Body contouring after weight loss describes several areas being assessed together. A thigh lift can be part of that plan; which areas are operated on in the same session is a separate decision.⁶ It does not follow from this article that all areas need operating on together.

Who is it suitable for?

It can be considered for people with excess skin on the thigh whose weight is relatively stable and whose conditions affecting wound healing or surgical risk have been assessed.² The excess may not concern appearance alone; complaints such as friction between the tissues of the inner thigh and difficulty with personal hygiene are part of the assessment as well.⁷

An average of 6 months of stable weight is sought before surgery. This clinical framework does not mean that suitability for surgery is gained simply by the interval elapsing. The American Society of Plastic Surgeons likewise considers relatively stable weight, general health and realistic expectations together in candidacy.² Its candidacy page does not give a fixed weight or body mass index threshold.²

Whether a skin-excision procedure that will leave a scar is accepted is an important part of the decision.⁵ Expecting the scar to be covered entirely in open clothing and wanting the excess skin reduced are not the same expectation. Whether a short-scar operation is suitable is also determined by the distribution of the excess, not by a preference about the scar alone.⁸

What does the examination assess?

Skin quality, the amount of the excess and the areas it extends to, the distribution of subcutaneous fat and existing scars are assessed.⁷ In planning the incision, not only the appearance of the thigh from one direction but the inner side and its relationship with the groin are examined.⁸⁷ Differences between the two sides at the outset and the correction expected are explained.⁴

Any pre-existing leg swelling, lymphoedema, venous problem or history of a clot should be declared.⁷ It is not assumed that swelling present at the outset and a new swelling that may occur after surgery are the same problem. Assessing lymphatic and venous problems before surgery is part of the surgical plan.⁷

Previous operations, medication in use, cigarette and nicotine use, coexisting illnesses and any previous problems with wound healing are taken into the assessment.⁴ How much the person sits, stands and walks in daily life, and the help available at home, are also established in order to build the care plan. Sedentary work is not accepted as a job that puts no strain at all on the leg and the groin incision.

How is the operation planned?

Is excess skin or fatty tissue the main issue?

Excess fatty tissue and laxity of the skin are assessed separately. Where skin elasticity is adequate, liposuction alone may be suitable in some people; where there is marked excess skin, the skin needs removing.¹ The scope of a thigh lift is not described through the amount of fat to be removed.

Excess skin remaining confined to the upper thigh and extending further down the inner side can require different incision plans.⁸ At examination the position of the excess, skin quality and fatty tissue are assessed together; the same incision pattern is not applied to everyone.⁷

Where is the incision made, and what determines its length?

The incision is planned on the inner side of the leg, extending into the groin where needed. Its choice is determined by the amount of excess skin and subcutaneous fatty tissue. Horizontal patterns confined to the groin, vertical patterns extending down the inner side, and combinations of the two are described in the literature.⁸⁷ These names are not an order of superiority between methods.

A short-scar option can be planned in suitable people; no promise is made that an excess extending over the whole thigh can be corrected with the same short incision.⁸ The scar is planned on the inner side so as to be less noticeable at first glance from the front and the back. In open clothing it is not possible to hide the scar entirely. Planning it on the inner side does not mean the scar will be invisible.⁵

How is liposuction added?

Liposuction is added to the operative plan according to the amount of subcutaneous fat. Adjusting the fatty tissue and removing excess skin carry different aims.¹ The tissue to be removed and the area to be worked on are determined at examination; it is not said that the same amount of fat will be removed in everyone.

Adding liposuction does not mean that the wound healing or lymphatic risks of a thigh lift are removed. The studies assessed different applications of liposuction and different patient groups; their findings should not be combined into a single direction of risk for all applications of liposuction.⁹¹⁰ The position and extent of an added procedure are assessed separately; the decision on liposuction is determined at examination.

How does it differ from a lower body lift?

Removing the excess on the inner side of the thigh and addressing sagging of the buttocks, the flanks and the outer thigh together are not the same in scope; the order and timing of several areas are the subject of a plan for body contouring after weight loss.⁶ An operation on the inner side is not expected to have the same effect on the whole lower body. Adding a tummy tuck or a procedure in another area requires the incision and healing plans to be assessed together.⁶

A lower body lift concerns the position of the tissues and excess skin.⁶ Buttock augmentation carries the aim of adding volume; the names here are not used in place of one another.¹¹ Needing more than one area does not mean that all of them have to be done in the same session.

How are anaesthesia and the hospital stay planned?

The operation is carried out under general anaesthesia. 2-3 hours are expected for the operation and 1-3 nights for the hospital stay. The extent of the procedure and the check-up findings in the early period are assessed. The total plan formed by adding other operations is explained separately; the interval here is not a fixed total for all procedures in other areas.

A drain is usually used. A drain can help to remove excess fluid or blood beneath the incision.¹² The day it is removed is not given as fixed; it is assessed at check-ups. Leaving hospital does not mean that care of the drain and the dressing is complete, or that all movements are permitted.

How do you prepare for surgery?

Smoking and nicotine: Smoking is a risk factor for wound healing problems after surgery. Direct surgical data on nicotine products other than cigarettes are scarcer. The practice reference of the American Society of Plastic Surgeons notes a lack of clinical data on e-cigarette use and surgical risk, but states that because nicotine is known to reduce blood flow, e-cigarettes and other nicotine products are regarded as a potential risk factor.¹³ Stopping smoking, vaping and other nicotine-containing products at least 1 month before the operation, and not using them after surgery until healing is complete, is therefore advised. The studies below concern smoking cessation; their results do not establish the same reduction in risk for every nicotine product. A review pooling 6 randomised and 15 observational studies showed that every week of abstinence added benefit, and that studies with at least 4 weeks of abstinence produced markedly better results than shorter ones.¹⁴ A study appraising systematic reviews together reported that cessation interventions beginning at least 4 weeks before surgery and combining multiple behavioural support sessions with pharmacotherapy reduced complications. The same study notes that interventions with only one component, even when started more than 4 weeks before surgery, raise quit rates without reducing complications.¹⁵ Shorter intervals are not useless either: in a meta-analysis of 55 studies covering adults undergoing a range of operations, the risk of pulmonary complications was 27 per cent lower in relative terms among those who stopped at least 2 weeks before surgery, and 29 per cent lower among those who stopped at least 4 weeks before, compared with those who continued smoking.¹⁶ The benefit therefore grows as the interval lengthens; being late does not make stopping pointless. The interval applied and the nicotine policy can vary from surgeon to surgeon.

Coexisting illness: Diabetes and blood pressure are expected to be under control before surgery. Where there is an active infection in the body, surgery is postponed.

Medication: Blood thinners and some herbal products can increase bleeding. Every medicine and supplement you take needs to be declared. Prescribed medication should not be stopped on your own decision.

Tests and anaesthetic assessment: The tests required are determined by general health and by the anaesthetic assessment.¹⁷ Any previous problem with anaesthesia or drug allergy should be declared. The instructions given about fasting and about how to take medication on the day of surgery are followed.

Home and transport: Someone is arranged to accompany you home on discharge.¹⁷ The timing of check-ups, the help you may need in the first days and the plan for time off work are organised beforehand. Follow the surgical team's guidance on preparing the operation area; do not shave or prepare the incision area at home on your own initiative.

The help that may be needed in the first days for getting out of bed, short walks, sitting and using the toilet is arranged in advance. Practical guidance is taken from the surgical team so that these movements are not carried out in a way that stretches the incision line.¹² Who will help at home and how you will get to check-ups are settled before discharge.

What is recovery like?

Swelling and bruising can occur after surgery; the first appearance is not the final result.⁸ The first check-up takes place within the first week. 2 weeks are expected for stitch removal. The state of the incision and the dressing is assessed at check-ups. Stitch removal is not on its own permission for long walks or for every way of sitting.

7-10 days are expected for bruising to settle and 2-4 weeks for marked oedema to subside. Residual slight swelling can last 3-4 months. The shape becomes assessable within 3-4 months. These intervals do not mean that swelling should end completely on a single day.

Swelling is expected to decrease over time; swelling that is new, grows rapidly or gathers markedly on one side is not left to wait within the same framework.¹⁸ The cause of prolonged oedema is assessed by examination. Not every prolonged swelling is lasting lymphoedema; a collection of fluid, a problem with lymphatic flow and a venous clot are different conditions.⁷¹⁸

6-8 weeks are expected for a full return to daily life. The compression garment, work, sport, assessment of the shape and maturation of the scar are separate timetables. The end of garment use does not mean that all activities are permitted; nor does the scar continuing to change mean that a return to daily life has to wait until it has finished changing.

What to pay attention to after surgery

The following is a general framework. Where the instructions you were given differ, your surgeon's instructions apply.

Drain and dressing: A drain is usually used; when it is removed is determined by the check-up findings. The dressing is continued according to your surgeon's advice until the wound has healed. The drain is not tugged, is not removed on your own initiative, and its connections are not altered outside the instructions given. Removal of the drain does not mean that care of the incision has ended.

Compression garment: It is worn for 2-4 weeks, including at night. The arrangements for putting it on, taking it off and cleaning it are determined by the surgical team's instructions. The garment is not tightened in the belief that firmer use will give a better result. Where there is marked pain, new numbness or a change in skin colour, assessment is requested. The end of garment use is not the lifting of the restrictions on sitting and walking.

Sleeping: Rest with the head elevated. Your surgeon decides how long that position and the avoidance of physical strain are continued. A sleeping position that puts no pressure on the incision is preferred. Returning to sleeping on the side or front is assessed according to the state of the incision and the swelling.

Lying, specific to the legs: Elevating the legs is advised. Elevating the head and supporting the legs are applied together within the same plan for lying; raising the head alone does not take the place of supporting the legs. The position of the support and of the legs is arranged as shown by the surgical team so that no pressure or tension is created on the incision line. Where other areas have been operated on as well, a plan for lying that takes all the incision lines into account is followed.

Cold application: Cold is applied to the operated area without pressing on it. The form and duration of the application are determined by your surgeon's instructions.

Showering, wound and dressings: When you may shower depends on the dressing used. If there is a skin incision, once allowed you can shower without rubbing the wound and pat the area dry gently. Baths, swimming pools and the sea wait until the wound has closed completely.

Shower timetable: A return to showering is assessed within 1-2 weeks, according to the state of the wound and the dressing. Removal of the drain is not by itself permission to shower. The care instructions given for the incision on the inner side and, where present, its extension into the groin are followed; crusts are not picked off.

Hygiene and clothing where there is a groin incision: Moisture in the groin crease and friction with movement can affect wound healing.³ Cleaning and dressing are continued in the manner given by the team. A published account of care notes that gentle cleaning and a dry dressing help to reduce irritation and odour.⁶ This information is not an instruction to clean every wound at the same frequency or to apply an antiseptic on your own initiative. How you sit down and stand up in the toilet, and the help needed, are arranged according to the movement plan given. Where underwear or the compression garment rubs or presses markedly on the incision, the team is informed; the garment is not tightened or cut on your own decision.

Movement: Strain such as bending the head down, straining and heavy lifting is limited in the early period. Movements that stretch or rub the incision area are avoided. Even if you feel well, do not return to strenuous activity suddenly. Activity and rest through the day are organised according to the plan given on discharge.

Sitting and walking: These are limited in the early period; afterwards they are freed to the extent your surgeon allows, according to the course of healing. Closure of the incision line, the course of the swelling, and the pain and tension a movement produces are assessed together. A short, assisted walk is not the same activity as walking a long distance, using stairs frequently or sitting for long periods. Rather than a fixed number of weeks, the check-up findings and the movement to be carried out are taken as the guide. Do not stay in bed all day on your own decision; continue the permitted short walks and the rest intervals according to the plan given.

Pain: There can be tenderness, tightness and pain in the legs.¹⁸ The painkillers given are used as instructed. Pain that markedly prevents walking or changing position is reported to the team; rather than abandoning the movement plan altogether, pain control and the need for help are assessed. No new painkiller or additional medicine is started on your own decision.

Returning to work and sport: 4-6 weeks are set aside for a return to work. In jobs involving long periods of sitting or standing, or constant strain on the legs, suitability is assessed separately. A return to sport is planned in stages within 6-8 weeks; approval from your doctor is awaited for activities that strain the leg under load. 6-8 weeks are expected for a full return to daily life. The work timetable running its course does not by itself lift the personal limits given for sitting and walking.

Driving: A return can be assessed within 4-6 weeks. There must be no effect of medication reducing attention, no dizziness and no pain preventing movement. You need to be able to sit with a seat belt, to check your surroundings and to brake suddenly or manoeuvre comfortably. The strain on the incision line while sitting is assessed as well as the leg's use of the pedals. Where these conditions are not met, driving is not undertaken even if the timetable has run its course. Someone accompanies you home on discharge.

Sexual activity: A return can be assessed once everyday movements no longer cause marked pain and you feel comfortable. Pressure on the leg area, movements that stretch the incision line, and marked straining are avoided. Rather than a fixed day, the course of healing and the surgeon's advice are taken as the guide.

Smoking: Smoking impairs wound healing after surgery as well; cigarettes and nicotine products should be avoided until healing is complete.

Findings that are normal: Bruising, swelling, tightness and altered sensation around the incision can occur.¹⁸ What matters is that the findings are decreasing. Swelling that grows rapidly, is painful, or gathers markedly on one side should not be attributed to the healing period given alone. Where there is a new fullness, no attempt is made to press on the area to drain fluid.

How are early walking and prevention of clots planned?

Walking is begun 6-8 hours after leaving the operation, on the assessment of the healthcare team. This early walking is not the same thing as a return to sport. The need for rest does not mean remaining motionless in bed throughout the day; the movement plan given by your surgeon is a basic part of care. Help is taken at the outset; where there is dizziness or marked weakness, you do not push on and the team is informed.

What begins here is a short, controlled first walk supervised by the healthcare team. Sitting and walking being limited in the early period does not mean that this first walk is not carried out. Increasing the duration or distance of walking requires assessment of the wound and of movement. Where even the short movements permitted cannot be carried out because of pain, the team is informed rather than remaining entirely still.

The risk of clots is assessed routinely before surgery. A compression stocking is put on before the operation; after surgery it is removed by the surgeon's decision once you have begun to walk comfortably. The plan for the compression garment used for the operated area and the plan for the stocking used to prevent clots are not confused with one another.

Where operations will be long, or where there are risk factors creating a predisposition to clots, prevention with medication is assessed. Which measures are applied together is determined according to the person's risk. Walking, a stocking or medication being used should not be thought of as removing the possibility of a clot altogether.

How do the scars change?

A permanent incision scar forms after a thigh lift; its length and position depend on the extent of the excess to be removed.⁸⁵ The scar is planned on the inner side so as to be less noticeable. It can be visible because of the cut of open clothing and the position of the leg. Planning it on the inner side is not a promise that the scar will be invisible; the position is an aim, not a guarantee of the result.

6 months to 1 year is expected for a scar to mature. Widening, raising or marked redness can remain; the final appearance of the scar cannot be predicted with certainty before surgery.³⁷ Choosing where the scar will sit and knowing how it will heal are not the same thing.

Scar care: Silicone gel or a silicone sheet is used after the wound has closed and your surgeon considers it suitable. No product is applied on your own initiative to an incision that is open, discharging or not yet healed. Which form of product is used, when and how, is determined by the check-up findings. Where irritation develops, an assessment by your doctor is sought regarding use of the product.

Silicone may help a scar to become softer and less red; it is not applied to an open or weeping wound.¹⁹ Stitches having been removed does not mean that silicone can be started on an open wound in the groin or in another area. Scar care and the dressing of a wound that has not yet closed are kept separate.

Risks and complications

Wound healing problems, fluid collection, altered sensation and scar problems can occur after a thigh lift.¹⁸ The order below is not an order of frequency. Numerical data existing for some outcomes does not mean that a problem without a figure is unimportant or necessarily rarer.

In Table 2 of a meta-analysis, the following pooled rates were reported for the thigh lift subgroup.²⁰ The brackets give the 95 per cent confidence interval. Procedures involving a horizontal incision in the upper inner thigh were assessed; procedures with a vertical incision only were excluded.²⁰

• Seroma 7 per cent (3-12); denominator 207.²⁰
• Haematoma 4 per cent (1-7); denominator 133.²⁰
• Wound dehiscence 20 per cent (8-33); denominator 138.²⁰

The studies are retrospective, and no common follow-up period is given for this subgroup.²⁰ The variation between studies is very high for wound dehiscence, so the figure of 20 per cent is not a fixed number representing the rate to be expected in individual studies.²⁰ These values do not apply directly to all incision patterns or to one person. Adding different events and denominators together does not give a total complication risk. The rates for the reconstructive flap groups in the same publication are not used here.

Wound dehiscence, delayed healing and infection

Wound dehiscence and delayed healing are prominent problems in thigh lift surgery.⁹ The figure for wound dehiscence above belongs to the general thigh lift subgroup; it is not a separate percentage for the groin incision.²⁰ The groin crease is the area where delayed healing can particularly be seen, because of moisture and friction with movement.³

Skin quality, weight, the tension on the incision line, coexisting illnesses and factors that delay healing are assessed together.⁷ Loss of skin or fatty tissue, infection and irritation related to the stitches can also develop.¹⁸ A wound opening does not always mean major further surgery; wound care may be needed for small openings.⁶ The treatment required is determined by the state of the opening.

Where there is increasing redness, discharge, fever or separation of the wound edges, the planned check-up is not waited for. Routine dressings and check-ups are continued; no scar product or other product is applied to an open wound without your doctor's advice.

Bleeding and seroma

A haematoma is a collection of blood and a seroma a collection of tissue fluid in the operated area; both have been reported after a thigh lift.²⁰ A newly developing asymmetric fullness, increasing tightness or pain may require assessment.⁶ Ordinary bruising and a growing collection of blood are not told apart at home by appearance alone.

Where a collection of fluid develops, a further check-up, drainage or another intervention may be needed.⁶ A drain having been used or removed does not remove that possibility. No attempt is made to drain fluid by pressing on the area, or to solve the problem by altering the drain connection.

Swelling, lymphatic flow and lasting lymphoedema

The lymphatic vessels on the inner side of the thigh play a part in carrying fluid, and preserving these structures during surgery is important.⁷ A lymphocele describes a collection of lymph fluid in a limited area; lymphoedema describes tissue swelling related to a disturbance in lymphatic transport.⁷ Not every swelling after surgery is one of these.

In the abstract of a study of 106 people who had a thigh lift after marked weight loss, oedema was reported to have developed in 25 people and, in 2 of them, still not to have resolved at 12 months.⁹ The possibility of prolonged swelling is therefore not disregarded. Those 2 people in the abstract are not, however, presented as people diagnosed with lifelong lasting lymphoedema.⁹

In another prospective study, 14 people were assessed and lymphoscintigraphy was abnormal in 8 of the 26 lower limbs meeting the conditions for analysis 6 months after surgery.²¹ What is measured here is an imaging finding of lymphatic circulation; it is not 8 people or 8 cases of lasting lymphoedema. That study assessed thigh lift surgery after bariatric surgery, not cancer surgery or the removal of lymph nodes.²¹

Swelling can settle over time; alongside that, the possibility of lasting lymphoedema is also described.³ The studies given in this article do not provide a separate, reliable personal risk percentage for lasting lymphoedema. Swelling that is prolonged, increasing again, or affecting the use of the foot and the leg needs checking; the timetable for residual slight swelling is not a reason to leave new findings waiting.

Altered sensation and nerve injury

There can be numbness, altered sensation or prolonged pain around the incision.¹⁸ In an anatomical study assessing the sensory fields of the anteromedial thigh, the fields of the medial femoral cutaneous and intermediate femoral cutaneous nerves and of the infrapatellar branch of the saphenous nerve were shown to vary between individuals and to overlap.²² The distribution of altered sensation is therefore assessed separately at examination.

This anatomical study was carried out in healthy volunteers; it is not a study of the frequency of nerve damage after a thigh lift or of when sensory loss resolves.²² Transient numbness and lasting loss of sensation are not counted as the same outcome. Newly developing or spreading loss of sensation, marked burning and new weakness related to movement are not accepted as ordinary sensation around the incision; they are reported to the team.

Problems relating to shape, symmetry and the scar

Further correction may be needed because of asymmetry, remaining excess skin, recurrent laxity or a marked scar.¹⁸⁵ Traction on the tissues neighbouring the groin and a change in the shape of the genital area have also been described.⁷ These problems are taken into account in the incision plan and in assessing the scar.

A decision on the lasting result is not made from the differences seen during the early period of swelling.⁸⁵ Treating widening or raising of the scar and correcting remaining excess skin are not the same intervention. The decision on further surgery is assessed according to what the problem is, the course of healing and the benefit expected.⁵

Clots and general surgical risks

Blood clots: A clot forming in the leg veins and travelling to the lungs is serious. One-sided leg pain and swelling, sudden shortness of breath or chest pain need urgent assessment.

The approach to preventing clots is decided according to the person's risk and the operation planned. The measures to be used are explained in the discharge and care plan. No blood thinner is started without being prescribed, and existing treatment is not altered on the person's own decision.

Problems related to anaesthesia and cardiac and pulmonary complications are also part of the assessment for surgery.¹⁸ The risk assessment before surgery is applied together with early walking, stockings and, where needed, prevention with medication. A preventive measure being used does not lessen the importance of new symptoms.

Risks relating to added procedures

Where liposuction or surgery in another area such as an arm lift is added, all the operated areas are assessed together.⁶ A way of lying or getting up that suits one incision line can strain another; a shared movement plan is explained on discharge.

A complication percentage reported for a thigh lift is not added to that of a tummy tuck or another operation to calculate a combined risk. The extent of the procedures to be carried out, general health and how care can be managed are considered together.⁴ No fixed order, or staged plan obligatory for everyone, follows from this article.

Does the result change over time?

Changes in weight and ageing can alter the appearance of the thigh again.⁵ The American Society of Plastic Surgeons states that results can last a long time where stable weight and general fitness are maintained, and that some loss of firmness with age is natural.⁵ That account is not a guarantee of the same appearance for a particular number of years or for life.

Recurrent laxity, excess remaining from the first operation and a scar problem are assessed differently.¹⁸⁵ Whether more than one correction is needed can vary between people; another person's follow-up period does not create a timetable for further surgery for everyone.

What can be expected from the result?

The change expected is a reduction in the excess skin on the inner side of the thigh and an adjustment of the fatty tissue according to the plan.¹ It should be known that a permanent incision scar will form in return.⁵ Although the scar is planned on the inner side, it is not guaranteed to be hidden entirely in open clothing. Whether that scar is accepted matters as much as the change in the excess skin.

Returning to work or to driving is not the same decision as being able to use the leg under every load. The compression garment's period running out does not automatically lift the limits on sitting and walking. A full return to daily life, assessment of the shape and maturation of the scar are separate steps.

When should you contact a doctor?

In the situations below, the planned check-up is not waited for.

• Rapidly increasing swelling, new tightness or marked one-sided fullness in the thigh
• Pain that increases rather than settling, or becomes marked despite the pain treatment given
• Fever, spreading redness or discharge from the incision line
• The wound opening, particularly in the groin or the inner-side incision, or bleeding that does not stop
• New loss of sensation, spreading burning or weakness in the leg or the foot
• Newly developing marked pallor, darkening or blistering of the skin
• The drain coming out of place, or increasing swelling while its output changes
• Steadily increasing pain or pressure under the compression garment

These findings may require assessment for bleeding, fluid collection, infection, wound healing or sensory problems.¹⁸⁶ Rather than trying to work out the cause of a new swelling at home, report it to the surgical team. The drain having been removed, or the check on the stitches having been completed, is not a reason to leave new findings.

One-sided leg pain and swelling, sudden shortness of breath or chest pain are emergencies. Where there is a sudden breathing problem in particular, urgent assessment should not be delayed while trying to reach your doctor.¹² The operation having been carried out on the leg does not by itself make one-sided painful swelling ordinary.

About the numbers in this article

The intervals given for the operation, hospital stay, stitches, compression garment, showering and return to activity, together with those for bruising, swelling, shape and the scar, are the approved clinical framework. No fixed number of weeks is given for sitting and walking. An early short walk and a long walk or sport are not the same permission.

The pooled rates in the risk section belong to the thigh lift subgroup of one meta-analysis and are given with their confidence intervals.²⁰ The follow-up periods in the swelling and lymphoscintigraphy studies are not a waiting timetable to be applied to everyone after surgery.⁹²¹ The number of people and the number of legs assessed, ordinary oedema and lymphoedema, and an imaging change and a clinical diagnosis are not used in place of one another.

The shared paragraph on smoking cessation reports research covering a range of operations.¹⁴¹⁵¹⁶ The relative risk reduction is not an absolute complication rate specific to thigh lift surgery, nor does it mean that every nicotine product has been studied separately with the same effect.

References

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16. Tang E, Rodriguez RM, Srivastava A, et al. Impact of short duration smoking cessation on post-operative complications: a systematic review and meta-analysis. J Clin Anesth. 2025;106:111967. doi:10.1016/j.jclinane.2025.111967 ↩ ↩²

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